Metacarpophalageal Joint Dislocation 834.01

synonyms:

Metacarpophalageal Joint Dislocation ICD-9

• 834.01  closed dislocation Metacarpophalageal Joint
• 834.11  open dislocation Metacarpophalageal Joint

Metacarpophalageal Joint Dislocation Etiology / Epidemiology / Natural History

• Generally caused by a fall on the outstretched hand causing forcible hyperextension of the MCP joint. Volar dislocations may result from hyperflexion injury. 
• Dorsal dislocations >> volar dislocations5
• Index finger is most frequently involved, followed by the thumb.
• The volar plate is avulsed from its metacarpal neck attachment during dorsal dislocation and may become interposed within the joint preventing reduction. Other structures may also prevent reduction: lumbrical muscle,  flexor tendons,  natatory ligament, superficial transverse metacarpal ligament.
• Volar dislocations may be irreducible due to: dorsal capsule, distal insertion of the volar plate, collateral ligament,  tendinous juncture connecting the fourth and fifth extensor digitorum communis tendons, dorsal
  interosseous muscle, sesamoid bone.

Metacarpophalageal Joint Dislocation Anatomy

• Proper collateral ligaments are the primary stabilizers of the MCP joint: taut in flexion, lax in extension.
• Accessory collateral ligaments originate volar to the proper collateral ligaments and insert onto
  the volar plate;  taut in extension and lax in flexion.
• Volar plate: thick fibrocartilaginous portion distally and a looser, membranous portion proximally.

Metacarpophalageal Joint Dislocation Clinical Evaluation

Metacarpophalageal Joint Dislocation Xray / Diagnositc Tests

Metacarpophalageal Joint Dislocation Classification / Treatment

Metacarpophalageal Joint Dislocation Associated Injuries / Differential Diagnosis

Metacarpophalageal Joint Dislocation Complications

• Nonuion
• Infection
• Painful hardware
• Compartment Syndrome
• CRPS
• DVT / PE
• Heterotopic Ossification

Metacarpophalageal Joint Dislocation Follow-up Care

Metacarpophalageal Joint Dislocation Review References

• Dinh P,  JAAOS; 2009 ; 17:318